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BMS13 > Liver & Pancreas > Flashcards

Liver & Pancreas Flashcards

1
Q

How do pancreatic secretions travel to the duodenum?

A

Pancreatic duct –> common bile duct –> sphincter of Oddi

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2
Q

What percentage of the pancreas has an endocrine function?

A

1-2%

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3
Q

Which salivary gland does the exocrine pancreas resemble?

A

Parotid

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4
Q

How many enzymes are formed by the pancreas for digestion?

A

15

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5
Q

Where are the nuclei in pancreatic enzyme producing cells?

A

At the base

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6
Q

What is the structure of the exocrine glands in the pancreas and what type of secretion occurs here?

A

Branched acinar

Merocrine (into a central cavity)

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7
Q

What are centroacinar cells?

A

Cells that partially line lumen of acinus/duct

Secrete HCO3-

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8
Q

How can you tell the difference between acinar and centroacinar cells?

A

Nuclei are at the centre in centroacinar cells and at the base in acinar cells

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9
Q

What is different about the ducts of salivary glands and the exocrine pancreas?

A

No striated ducts in the pancreas

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10
Q

What do the islets of Langerhans look like?

A

Pale-staining, small with profuse blood supply

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11
Q

What is produced by the islets of Langerhans?

A

Insulin

Glucagon

Somatostatin

Vasoactive intestinal peptide VIP

Pancreatic polypeptide PP

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12
Q

How are the cells arranged in the islets of Langerhans?

A

Arranged in columns/cords around a capillary

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13
Q

Why are pancreatic enzymes secreted in proenzyme form?

A

Prevent self-digestion

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14
Q

What are the eight functions of the liver?

A

Exocrine - produce bile for duodenum

Process absorbed nutrients

Metabolism of carbohydrates, fats and protein

Involved in storage of carbohydrates, fats and vitamins

Synthesise and secrete plasma proteins and lipoproteins

Detoxification of ingested toxins, drugs

Destroys old RBCs and reclaims iron

First site of haematopoiesis in the embryo

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15
Q

How many lobules are in a human liver and what shape are they?

A

1 million

Hexagonal

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16
Q

Why are the lobules of the liver hard to distinguish in humans?

A

Less connective tissue between

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17
Q

How does the processed blood of a lobule enter the hepatic vein?

A

Sinusoids deliver to the central vein (of that lobule)

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18
Q

What are portal tracts?

A

Triad at vertices of liver lobules

Consist of a branch of:

  • Hepatic portal vein (largest)
  • Hepatic artery
  • Bile duct
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19
Q

What does the hepatic portal vein do?

A

Delivers blood containing nutrients from small intestine to the liver

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20
Q

What does the hepatic artery do?

A

Delivers oxygenated blood to the hepatocytes/liver

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21
Q

What does the bile duct do?

A

Collects bile produced by hepatocytes

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22
Q

Which way does blood and bile flow in a lobule?

A

Blood = towards central vein

Bile = away from central vein

23
Q

How are the hepatocytes arranged in the lobules and what do they look like?

A

Rows with sinusoids between; 1-2 layers of cells

Roughly cuboidal with microvilli

24
Q

Describe the sinusoids of the liver.

A

Discontinuous and fenestrated endothelial cell lining

2-3 RBC diameter

Contain Kupffer cells

25
Q

What is the function of the Kupffer cells?

A

Phagocytic - take up pathogens and particulate material

26
Q

Where is the space of Disse?

A

Between endothelial cell lining of sinusoids and surface/microvilli of hepatocytes

27
Q

What are the alternative names for Ito cells?

A

Hepatic stellate cells

Perisinusoidal cells

28
Q

What is the function of Ito cells?

A

Store vitamin A in lipid droplets

29
Q

Where are Ito cells found?

A

Space of Disse

30
Q

How can Ito cells cause liver cirrhosis?

A

Inflammatory stimuli (eg. alcohol) can cause Ito cells to transform into myofibroblasts

Produce large amounts of collagen and ECM

Blocks blood/nutrient flow across lobule

Hepatocyte death

31
Q

Why is it beneficial to have a discontinuous endothelial cell lining in the liver sinusoids?

A

Direct contact of blood with hepatocyte microvilli increases efficiency of transfer

32
Q

How is bile delivered to the bile duct from the hepatocytes?

A

Bile canaliculi –> bile duct branch of portal tract –> Bile duct

33
Q

Where are bile canaliculi found?

A

Between hepatocytes

34
Q

What do hepatocytes secrete?

A

Albumin

Fibrinogen

Clotting factors

35
Q

What prevents bile from moving between hepatocytes?

A

Tight junctions

36
Q

What does bile contain?

A

Bile salts

Bile pigments

37
Q

What are deoxycholate, sodium glycocholate and taurocholate examples of?

A

Bile salts

38
Q

What are bile salts and what is their function?

A

Breakdown products of cholesterol

Detergents to emulsify fats in duodenum

39
Q

What are the two bile pigments and what colours are they?

A

Biliruben - red

Biliverdin - green

40
Q

What are bile pigments?

A

Breakdown products of haemoglobin

41
Q

What is a liver acinus?

A

Body of tissue supplied by two triads

42
Q

Which zone is the most oxygen-rich in a liver acinus?

A

Zone 1

43
Q

What zone of a liver acinus would be affected first by phosphorus and why?

A

Zone 1

Immediately toxic to hepatocytes

44
Q

What zone of a liver acinus would be affected first by paracetamol and why?

A

Zone 3

Toxic breakdown products

45
Q

Describe how paracetamol is metabolised by the liver.

A

P450 used to convert paracetamol to a reactive quinone derivative

Reactive quinone derivative removed by glutathione

46
Q

What substance is used to replenish glutathione levels?

A

Methionine

47
Q

Why is an overdose of paracetamol so dangerous?

A

Glutathione supply depleted so reactive quinone derivative binds covalently to cellular proteins and kills cells

Liver failure

48
Q

Why should you not ingest barbiturates and alcohol with paracetamol?

A

They induce liver enzymes which potentiates the toxicity of paracetamol

49
Q

How much bile is stored in the gall bladder usually?

A

50ml

50
Q

How does the gall bladder concentrate bile?

A

Na/K-ATPase pump on BL membrane pumps Na+ across membrane (absorbed)

Water follows by osmosis

51
Q

What type of epithelium lines the gall bladder?

A

Tall, simple, columnar epithelium with irregular brush border

52
Q

Why does it look like there are cracks between the basal surfaces of adjacent cells lining the gall bladder?

A

Influx of water following NaCl pumping into interstitial space

53
Q

What stimulates the smooth muscle of the gall bladder to contract?

A

Cholecystokinin

54
Q

Where is cholecystokinin produced?

A

Cells in base of crypts of duodenum

BMS13 (7 decks)

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